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Este formulario se utiliza para que un miembro del personal de la escuela, en consulta con un administrador, refiera a un estudiante a los servicios de Consejería de Salud Mental Escolar.
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How to fill out smh referral form
How to fill out SMH Referral Form
01
Obtain the SMH Referral Form from the designated source (website or office).
02
Fill in the patient's personal information including name, date of birth, and contact details.
03
Provide the referring doctor's information including name, contact number, and medical practice details.
04
Indicate the reason for the referral by selecting from available options or providing a brief description.
05
Attach any relevant medical history or documents that support the referral.
06
Review the form for completeness and accuracy.
07
Submit the form as instructed (via email, fax, or in person).
Who needs SMH Referral Form?
01
Individuals seeking specialized medical care from SMH.
02
Primary care physicians or healthcare providers who need to refer patients to SMH.
03
Patients who have been advised by their healthcare provider to obtain a referral.
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What is SMH Referral Form?
The SMH Referral Form is a document used to refer individuals to specialized services or care provided by a healthcare organization.
Who is required to file SMH Referral Form?
Healthcare professionals, such as doctors, nurses, or social workers, who identify a patient needing referral services are required to file the SMH Referral Form.
How to fill out SMH Referral Form?
To fill out the SMH Referral Form, complete all required sections with accurate patient information, including personal details, the reason for referral, and any relevant medical history.
What is the purpose of SMH Referral Form?
The purpose of the SMH Referral Form is to facilitate the process of directing patients to appropriate care or services while ensuring that all necessary information is communicated effectively.
What information must be reported on SMH Referral Form?
The SMH Referral Form must report information such as the patient's full name, contact details, the referring provider’s information, the reason for referral, and any pertinent medical history.
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